This is a patient with extensive and severe keloids after burn injury. He was followed up by plastic surgery at a general hospital with only ointment prescription. Because of the severe contracture (pull), she was unable to straighten her back and her growth was severely affected. We devised a surgical design using a combination of -consecutive Z-plasty - 5-flap to remove the contracture. As expected, the skin defect could not be fully covered by the skin valve alone, so a small skin graft taken from the lateral thoracic region was added. After the surgery, to prevent the tightness (contracture) from recurring, compression with an adhesive splint and immobilization with a corset were performed for more than 3 months. This is called postoperative therapy and is so important that it determines half of the outcome. The patient, who was a five-year-old child at the time of surgery, is now in the upper grades of elementary school. So far, there has been no twitching even when the patient's back is straightened. As you can see, even keloids caused by severe burns can be improved to this extent with appropriately designed plastic surgery and careful postoperative care. Post-treatment treatment for keloids and scars lasts for three months, so we encourage the patient as if we were climbing a mountain together. I applaud the patient for a job well done!
Name of procedure
Anterior thoracic scar contracture plication / Stapedectomy / Total skin grafting / Abdominal scar contracture plication
Age
5 years old
Procedure Details
The contraction of the extensive hypertrophic scar from the shoulders to the upper abdomen is removed by continuous Z-plasty and the replacement of a penile skin valve,
The skin is then stretched in the vertical direction.
Next, a full-layer skin graft was placed over the skin defect from the right lateral thoracic area.
Postoperatively, the keloid is stretched and compressed in the vertical direction with an adhesive splint for 3 months or partially for 6 months.
Risks and Side Effects
Adverse reactions: subcutaneous hematoma, swelling, pain.
Downtime
1-2 weeks
Cost Including Tax
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